The zero suicide initiative is no pipe dream.
Targeting the overwhelming majority of those that commit suicide—people suffering from mental illness—millions of dollars are being invested in new advanced suicide prevention systems and technologies, including new cutting-edge augmented mental health innovations.
In this article, we introduce the smart arm of the zero suicide initiative, stemming from the budding augmented mental health industry, touching on the exciting new digital technology innovations actualizing zero suicide in the present day!
Mental Health & the Zero Suicide Initiative
Galvanized by the National Action Alliance for Suicide Prevention’s Zero Suicide Model presented back in 2012, scientists, experts, and advocates across the globe are making zero suicide their mission:
“Zero suicide is a global movement that has called upon and joined together suicide prevention experts from across the globe; to research, evaluate and share prevention successes. The result is continuous improvement and dissemination of tools and instructions for healthcare professionals, equipping them for effective and caring interactions with those experiencing the despair of suicidal thoughts.” ~zerozuicide.org
Founded on the principle that suicide is wholly preventable in behavioral health systems, the Zero Suicide Model offers an evidence-based, integrated, system-wide strategy for suicide prevention.
Currently, the second leading cause of death among 15-29-year-olds on the globe, with suicide rates in many countries (including the US) reaching all-time highs, the millions of dollars now being injected into the rapidly evolving zero suicide approach is rightfully received.
With the rise of big data, the IoT, and smart and connected devices, the emerging augmented mental health industry—that leverages these technological developments to launch mental health care into the 21st century—is the anticipated route to fully implementing zero suicide models and making advanced suicide prevention and zero suicide a reality.
Augmented mental health is based on real-time big data analysis from behavioral and physiological signals collected with popular smart devices. This permits population-level access to highly personalized and remote mental health care and monitoring that can be maximally tailored to serve any individual. A clear frontrunner in securing the feasibility of the zero suicide endeavor.
As described in a recent Brain Science journal article by Dr. Xavier Briffault from the French National Centre for Scientific Research, and colleagues:
“These new devices thus offer new possibilities for spatial, temporal, and thematic extensions of psychiatric, psychotherapeutic, psycho-educational, medical relationships...whose observation and intervention potential can now be extended far beyond consultation to potentially concern all areas of life, at any time and in any place, while integrating the possibilities for automatic analysis and analysis assistance offered by data-mining and deep-learning technologies.”
Augmented Mental Health Systems for Zero Suicide
Research places the systematic use of evidence-based prevention, intervention, and postvention as a zero suicide tenant.
The myriad of detailed nuances of evidence-based, deeply personalized, and round the clock care that can be achieved for suicide prevention is arguably infinite with augmented mental health.
Augmented mental health platforms for zero suicide professionals will ultimately provide an integrated suite of mobile applications tailored to patient/therapist’s choice that is continually reprogrammed according to the patient’s ever-changing mental health status and suicide risk level.
Generally speaking, such platforms are capable of:
Jo: A Fictional Case
Like the majority of people that take their lives, Jo is an adult male. In his 30s, he’s an adventurous, fun-loving, and successful graphic designer. Having suffered complicated grief from the loss of his mother as a child, like the majority of people that consider taking their lives he sought professional help.
He had 2 years of successful outpatient therapy for depression and active suicidal ideation in high school, where he first started using the nation-wide, augmented mental health app and advanced suicide prevention healthcare services.
He hasn’t had face-to-face therapy in years, yet both Jo and his therapist receive an alert while he is out of town for business that indicates old patterns and early warning signs are returning. Jo’s therapist is in a meeting, and so an advanced AI optimized to enhance the therapeutic relationship has a quick interaction with Jo and discerns that although he does not need emergency services, he should speak with his therapist immediately.
Avoiding the potentially devastating costs of untreated depression, after an instant video chat with his therapist, they arrange for a more indepth holotherapy session that evening in his hotel room to agree on the best personalized mental health therapy plan moving forward.
His productivity at work is down, even the smallest tasks are seeming monumental, the motivation for and pleasure in usual activities are waning again, and this business trip has him on edge. On top of it all, previously stable relationships are coming undone and he is feeling out of touch and distant from his friends.
Meeting with his therapist, they review his automated behavioral health report that reflects the recent changes in his mental and behavioral health. Social stats were waining as he became increasingly isolated; feelings of shame, depression, and anxiety were on the up; and his data indicated self-harm ideation.
The report prompted Jo to confide in his therapist that he had “caught himself” ruminating about the release of cutting himself that he had not felt in years, and intrusive passive suicidal thoughts of ending his own life were taking root.
Together, they agree to update the app to reflect his elevated suicide risk status and suicide prevention measures, ensuring he has the optimal support for his needs, not just from therapy but from his employers and insurers also. Likewise, he adds his brother and flatmate to the alerted support team to help him transition back to wellness and to be on call upon automated detection of emotional distress.
They also decide upon and initiate a personalized treatment: a continually updated remote intervention and guided therapy plan are prescribed to his personal device.
The report, the therapist, and Jo all agreed that, for him, right now, CBT and lifestyle changes related to nutrition and fitness were key to improving his current mental health status and reducing his suicide risk. The appropriate goals were set for improving his mental health and wellness, including the auto-scheduling of weekly therapy sessions that will include the intervention fine-tuning based on his progress.
Ultimately, in a technologically augmented, mentally healthy, and zero suicide world, the augmented mental health app drastically increased the chances (as close to a guarantee as is humanly possible) of Jo receiving the right care at the right time in minimizing the risk of losing his life.
Augmented Mental Health and Zero Suicide Today
The fictional case presented above isn’t necessarily the description of some long-distant future. The early permutations of these emerging services and technologies have already landed in the form of some of the first augmented mental health applications that can aid the zero suicide initiative.
Take Objective Zero’s impressive suicide preemption technology project as an example.
They have already established the Objective Zero mobile app: the world's first mobile application to connect Veterans to nationwide peer support and mental health and wellness resources at the touch of a button. Their new, augmented mental health approach for suicide prevention takes this to the next level, incorporating advanced suicide risk monitoring, is eagerly anticipated.
Using machine and deep learning methodologies, Objective Zero are developing a suicide prevention algorithm to identify when someone is at risk of suicide and immediately get them the help they need.
The technology first collects user data and establishes a baseline of healthy behavior from which deviations are measured. The technology persistently compares new data to the baseline to identify troubling trends. When deviations are detected the app delivers the proper resources to the user at the exact moment they need them.
The augmented mental health tech will provide text, video, and voice connection to peer supporters, as well as mindfulness activities, emergency services, and information for local mental health resources.
Considering some of the highest suicide rates are found with mood disorders (e.g., up to 50% of bipolar disorder sufferers attempt to take their lives), augmented mental health technologies that seamlessly and objectively monitor mood in real-time are quintessential.
Without employing technology-fueled, augmented mental health approaches to suicide prevention that are positioned to be the mainstay of healthy living in a future IoT-compliant world, our hypothetical case Jo may not have made it past high school.
While the $3.5 million invested in the Office of Mental Health in New York to upgrade care systems to a zero suicide approach from federal Substance Abuse and Mental Health Services Administration (SAMHSA) Zero Suicide grant program marks the first of its kind in the US. Irrespective of the phenomenal changes such zero suicide community services are making, it is when zero suicide services are integrated and delivered within an augmented mental health framework, the emerging future of mental health care, that can effectively take implementing the zero suicide model from ‘almost zero’ to ‘zero’.
Stay tuned for a detailed exploration of how the augmented mental health innovations are addressing the seven elements of the Zero Suicide model in upcoming articles.
Brodsky, B., Spruch-Feiner, A., & Stanley, B. (2018). The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care. Frontiers In Psychiatry, 9. doi: 10.3389/fpsyt.2018.00033
Khandoker, A., Luthra, V., Abouallaban, Y., Saha, S., Ahmed, K., & Mostafa, R. et al. (2017). Suicidal Ideation Is Associated with Altered Variability of Fingertip Photo-Plethysmogram Signal in Depressed Patients. Frontiers In Physiology, 8. doi: 10.3389/fphys.2017.00501
World Health Organization. (2017). World health statistics 2017. World health statistics 2017: monitoring health for the SDGs, sustainable development goals. World Health Organization. Genève. ISBN 9789241565486
Stanley B. Zero Suicide: Implementation and Evaluation in Outpatient Mental Health Clinics. Las Vegas, NV: IASR/AFSP Suicide Research Summit; (2017).
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